Individual
MR. JEROME THOMAS CAMPBELL II
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3420 ILLINOIS STREET, USS TRANQUILLITY MEDICAL CLINIC, GREAT LAKES, IL 60088-5230
(847) 680-6175
Mailing address
410 NORTH GREEN BAY ROAD, APARTMENT #1015, WAUKEGAN, IL 60085
(847) 336-4228
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
03/29/2006
Last updated
07/08/2007
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